Individual
HEIDI BAUSCH-RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD, LP
Contact information
Practice address
1155 NORTHLAND DR, MENDOTA HEIGHTS, MN 55120-1288
(612) 223-8898
Mailing address
7601 WAYZATA BLVD, ST LOUIS PARK, MN 55426-1626
(612) 222-3889
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP6747
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/01/2015
Last updated
02/23/2022
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